Thank you for your interest in Khan Imports.  To request a Wholesale Price List, please print this form, complete and return by fax (805) 967-7128 or mail to:  Khan Imports • 126 N. La Patera Lane • Goleta, CA  93117-1512 A copy of your Seller's Permit, Resale Certificate, or Tax I.D. is required, and must be included with this form for your request to be processed. Store Name: ______________________________________ Billing Address: ______________________________________   ______________________________________ Shipping Address: ______________________________________   ______________________________________ Store Telephone: _________________ Home: _______________ Fax Number: ______________________________________ Website Address: ______________________________________ Your Name / Title: ______________________________________ E-Mail: (Required) ______________________________________ 1.  Please select the type of business. (Check all that apply.) ____ Department Store ____ Distributor ____ E-commerce Site ____ Executive Gifts ____ Florist ____ Furnishings / Decor ____ Furniture ____ General Gift ____ Interior Design ____ Manufacturer ____ Museum Shop ____ Nature Store ____ New Age ____ New Business ____ Showroom ____ Souvenir ____ Wholesaler Other _____________ 2.  How long has this store been open? ____ Store is not open yet.  (Please also indicate when store will open.) ____ 0 - 3 Months ____ 3 - 6 Months ____ 6 - 12 Months ____ 1 - 2 Years ____ 2 - 5 Years ____ Over 5 years 3.  Does this business have a website? ____ Yes, site address listed above. ____ No, we don't have a website. ____ Yes, site is under construction. ____ No, we're thinking about it. 4.  Does this business have a "physical" retail storefront location? ____ Yes, I listed the location above. ____ Yes, we have a location but have not opened yet. ____ Not at this time, we're thinking about it. ____ No, we retail through our website. Other Method of Retailing:  (Please specify.)  _______________________________________________ 5.  Does this business directly import any of it's own products? ____ No, we do not import. ____ No, we're thinking about it. Yes, we are currently or have imported from the following countries:  ______________ ______________ _____________ 6.  Please describe the "physical" location of this store. (Example:  Shopping Mall or Center, Main St., Downtown, Tourist Area, Show Booth, Kiosk, Fairs or Festivals, Home Based, etc.)  _______________________________________________  _______________________________________________ 7.  I am interested in the following product types: ____ All Product Types ____ Animal Figurines, Sculptures ____ Vases, Planters ____ Collectible Eggs, Spheres ____ Bowls, Trays, Wine Glasses ____ Pencil Holders, Paperweights ____ Decorative Boxes, Jars ____ Bookends, Obelisks, Pyramids ____ Candle Holders, Coasters ____ Marble Chess Sets 8.  I would like to request the following:  (Check all that apply.) A "print" catalog is included with inital orders.  Please reference our online catalog, or request to print a copy below. ____ Please e-mail me a link to your "printable" Wholesale Price List. ____ Please e-mail me a link to your "printable" Wholesale Catalog. ____ Please notify me by e-mail of special wholesale offers! ____ Please rush my request, I am interested in placing an order. 9.  Please sign this form prior to submission.  Thank you. I declare that all information provided on this form is correct and true. I agree that any pieces purchased from Khan Imports will not be marketed, presented or sold on the Internet (websites, auction sites, etc.) in any way. Signature  __________________________   Date:  ____________ (Required) All information provided is kept strictly confidential. Please include a copy of your Seller's Permit, Resale Certificate or Tax I.D. KHAN IMPORTS EST. 1989 Mailing Address: 126 N. La Patera Lane Goleta, CA  93117-1512  U.S.A. ~~~~~ Toll Free (800) 260-1064 (US & Canada) Int'l. Tel. +01-805-967-8050  •  Fax 1-805-967-7128 8:00AM - 4:00PM (Pacific Time) M-F E-mail:  wholesale@khanimports.com www.khanimports.com Copyright © 1999-2008, Khan Imports.  All rights reserved. No portion of this website, including product graphics, text or html code, may be copied, reproduced or published without written permission of Khan Imports. Copyright Policy & Legal Notices